Isu Pharmacist Clinic

LBN: Idaho State University
Isu Pharmacist Clinic is an health care organization with primary practice located at 4914 Yellowstone Ave Ste B , Chubbuck ID 83202-2332. The organization recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist, Ambulatory Health Care Facilities / Health Service. Ambulatory Health Care Facilities / Health Service is the primary health care specialty. Idaho State University can be contacted via phone (208) 282-2005, or through Rock, Cynthia Lee via phone (208) 373-1743.

Contact Information

Primary practice address
4914 Yellowstone Ave Ste B Chubbuck ID 83202-2332
Phone: (208) 282-2005
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Rock, Cynthia Lee
Phone: (208) 373-1743

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
Ambulatory Health Care Facilities / Health Service 261QH0100X

Profile Details

NPI number 1457060790
LBN Legal business name Idaho State University
DBA Doing business as Isu Pharmacist Clinic
Authorized official Rock, Cynthia Lee
Entity Organization
Organization subpart 1 No
Enumeration date Nov 15th, 2022
Last updated Jun 14th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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